AVP Quality Management Job

AVP Quality ManagementJob ID: 2011-15839 # Positions: 1Location: US-LA-Baton Rouge Search Category: NursingType: Regular Full-Time (30+ hours) Posted Date: 7/29/2011More information about this job:Summary:The AVP of Quality Management provides leadership in the development, coordination, implementation, and evaluation of the continuous quality improvement initiatives throughout the company in the areas of quality of care, quality of service, and provider/member satisfaction. Provides direction, leadership and education for compliance with NCQA standards to achieve and maintain NCQA accreditation. Maintains liaison with state and federal regulatory agencies. Supports health plan coordination of the quality management program across the company by sharing replicable technology, benchmarking, and best practices. Works to establish and promote a culture of organizational excellence.Responsibilities:1. Directs and provides leadership for implementing, monitoring and evaluating the Quality Management Program for the health plan ensuring the demographic and epidemiological needs of the population served are met.2. Establishes objectives and annual goals in conjunction with the CEO and Medical Directors.3. Oversees implementation and evaluation of the scope of the quality management program.4. Promotes plan-wide understanding, communication, and coordination of the quality management program.5. Directs and provides leadership for Plan compliance with NCQA standards.6. Provides leadership for the interpretation of results and development of improvement action plans arising from provider and member satisfaction surveys.7. Serves as a resource for design of quality improvement studies, indicators, data collection, and data trend analysis/interpretation.8. Provides leadership in developing, monitoring, and evaluating HEDIS improvement action plans.9. Participates in market development activities through due diligence activities.10. Provides leadership for health plan QM activities through sharing of replicable technology/benchmarking/best practices, assisting with review preparation, and providing guidance in quality improvement activities.11. Provides coaching for development of QM personnel.12. Works to establish and promote organizational excellence throughout the health plans.13. Monitors compliance with State and Federal quality improvement/assurance requirements.14. Evaluates and makes recommendations for oversight of delegated services.15. Develops the QM department annual operating and capital budgets to sufficiently meet departmental needs, and ensures the department stays within budget, and accounts for variances. 16. Interviews, manages, evaluates, and develops new and existing departmental staff.17. Recognizes and utilizes appropriate channels for communication, encourages two-way communication, and encourages staff to participate in creative program development.18. Effectively communicates information to superiors, team members, and other appropriate staff in a timely, accurate, and courteous manner.19. Provides leadership/facilitation for groups as needed.20. Represents Quality Management through group presentations on various topics for a variety of internal and external audiences.Qualifications:EDUCATION AND EXPERIENCE:Education- Bachelor Degree required.- MSN, MPH, MPA preferred.Years and Type of Experience Required: Required:- Minimum of 10 years experience in quality management, quality improvement, risk management, and/or utilization review in HMO setting and 5 years of leadership/management experience. - Previous NCQA accreditation and HEDIS reporting experience required.Specific Technical Skills- Required: Knowledge of basic computers including word processing and spreadsheets.- Preferred: Knowledge of data base applications preferred.Certifications or Licensure Preferred:- Current RN state license (or as required by Plan)- CPHQ preferred.Other- Strong knowledge base in areas of quality improvement, accreditation, HEDIS, satisfactory survey process, and organizational improvement.- Excellent written and verbal communication skills.- Ability to work effectively with physicians and other health care providers as well as with multi-disciplinary teams across department lines.- Excellent problem solving skills.- Demonstrates strong organizational skills.- Strong leadership, coaching, and staff development skills.- Ability to develop and give presentations and to facilitate groups.- Ability to handle multiple tasks.- Appreciation of cultural diversity and sensitivity towards target population.PHYSICAL REQUIREMENTS- Must be able to operate a computer.- Must be able to operate a phone.- Must be able to travel on common carriers and to adhere to AMERIGROUP's travel policiesermHO